@article{8992c739f6b74eee96eb5d21c7c1e7f0,
title = "The association between longer durations of the latent phase of labor and subsequent perinatal processes and outcomes among midwifery patients",
abstract = "Background/Objective: To evaluate the association between the duration of the latent phase of labor and subsequent processes and outcomes. Methods: Secondary analysis of prospectively collected data among 1,189 women with low-risk pregnancies and spontaneous labor. Results: Longer latent phase duration was associated with labor dystocia (eg, nulliparous ≥ mean [compared with < mean] aOR 3.95 [2.70-5.79]; multiparous ≥ mean [compared with < mean] aOR 5.45 [3.43-8.65]), interventions to ameliorate dystocia, and epidurals to cope or rest (eg, oxytocin augmentation: nulliparous > 80th% [compared with < 80th%] aOR 6.39 [4.04-10.12]; multiparous ≥ 80th% [compared with < 80th%] aOR 6.35 [3.79-10.64]). Longer latent phase duration was also associated with longer active phase and second stage. There were no associations between latent phase duration and risk for cesarean delivery or postpartum hemorrhage in a practice setting with relatively low rates of primary cesarean. Newborns born to multiparous women with latent phase of labor durations at and beyond the 80th% were more frequently admitted to the NICU (≥80th% [compared with < 80th%] aOR 2.7 [1.22-5.84]); however, two-thirds of these NICU admissions were likely for observation only. Conclusions: Longer duration of the spontaneous latent phase of labor among women with low-risk pregnancies may signal longer total labor processes, leading to an increase in diagnosis of dystocia, interventions to manage dystocia, and epidural use. Apart from multiparous neonatal NICU admission, no other maternal or child morbidity outcomes were elevated with longer duration of the latent phase of labor.",
keywords = "active phase of labor, labor duration, labor dystocia, latent phase of labor",
author = "Tilden, {Ellen L.} and Phillippi, {Julia C.} and Nicole Carlson and Mekhala Dissanayake and Lee, {Christopher S.} and Caughey, {Aaron B.} and Snowden, {Jonathan M.}",
note = "Funding Information: During this research, Dr Ellen Tilden received support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Institutes of Health Office of Research on Women's Health, Oregon BIRCWH Scholars in Women's Health Research across the Lifespan (K12HD043488-14). This source of funding had no involvement in any aspects of the research presented in this manuscript. During this research, Dr Jonathan M. Snowden and Mekhala Dissanayake were supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number R00 HD079658-03). During this research, Dr Julia C. Phillippi was supported by the Agency for Healthcare Research and Quality [grant number K08HS024733]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. Dr Nicole Carlson was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number K01NR016984 during research reported in this publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Funding Information: During this research, Dr Ellen Tilden received support from the Eunice Kennedy Shriver National Institute of Child Health and Human Development and National Institutes of Health Office of Research on Women's Health, Oregon BIRCWH Scholars in Women's Health Research across the Lifespan (K12HD043488‐14). This source of funding had no involvement in any aspects of the research presented in this manuscript. During this research, Dr Jonathan M. Snowden and Mekhala Dissanayake were supported by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (grant number R00 HD079658‐03). During this research, Dr Julia C. Phillippi was supported by the Agency for Healthcare Research and Quality [grant number K08HS024733]. The content is solely the responsibility of the authors and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. Dr Nicole Carlson was supported by the National Institute of Nursing Research of the National Institutes of Health under Award Number K01NR016984 during research reported in this publication. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2020 Wiley Periodicals LLC",
year = "2020",
month = dec,
doi = "10.1111/birt.12494",
language = "English (US)",
volume = "47",
pages = "418--429",
journal = "Birth",
issn = "0730-7659",
publisher = "Wiley-Blackwell",
number = "4",
}